AMISTAD COMMUNITY HEALTH CENTER, INCORPORATED

Criteria: The Health Center Program Cluster requires Amistad Community Health Center, Inc. to perform a financial assessment on consumers in order to place them on a sliding fee scale. The sliding fee scale must be based on the current Federal Poverty Guidelines. Condition: Forty (40) consumer files were tested for proper placement on the sliding fee scale. During the test it was noted that two (2) consumers were placed on an incorrect sliding fee scale due to calculation errors contrary to Amistad Community Health Center Inc.'s policy. The sliding fee schedule is used to determine eligibility for consumer discounts adjusted on the basis of the consumer's ability to pay. This schedule is based on the most recent Federal Poverty Guidelines. Questioned Costs: None Cause: Controls over placement of consumers on the sliding fee scale necessary for financial assessment of consumers are not operating effectively. Effect: Amistad Community Health Center Inc. may be subject to a decrease in Federal funding or a discontinuation of certain Federal grant programs, if deemed appropriate, from incorrect placement of consumers on the sliding fee scale. Recommendation: Amistad Community Health Center Inc. should review and modify the policies, procedures and training surrounding and regarding the sliding fee scale calculation and placement. View of Responsible Officials: See management's corrective action plan.

Criteria: The Health Center Program Cluster requires Amistad Community Health Center, Inc. to perform a financial assessment on patients in order to places them on a sliding fee scale. The sliding fee scale must be based on the current Federal Povery Guidelines. Condition: Patients are not always provided the appropriate sliding fee discount based on factors such as income and household size. Questioned Costs: None Context: Forty (40) consumer files were tested for proper placement on the sliding fee scale. During our audit it was noted that six (6) consumer files placement on various sliding scales was determined by using outdated proof of income and/or household size information, or was incorrectly calculated in general, in accordance with Amistad Community Health Center Inc.'s policy. The sliding fee schedule is used to determine eligibility for patient discounts adjusted on the basis of the patient's ability to pay. This schedule is based on the most recent Federal Poverty Guidelines. Cause : Controls over placement of patients on the sliding fee scale necessary for financial assessment of patients are not operating effectively. Effect: Patients were provided incorrect discounts for services provided by Amistad Community Health Center, Inc. Recommendation: Amistad Community Health Center Inc. should review and modify the policies, procedures, and training surrounding the sliding fee scale calculation and placement. View of Responsible Officials: See management's corrective action plan.